Columns, COVID-19: Inside the Global Epicenter
Leave a comment

A Construct for Uncertainty

by Dr. Kaile Eison, DO, physical medicine & rehabilitation resident physician in New York City, written for COVID-19: Inside the Global Epicenter: Personal Accounts from NYC Frontline Healthcare Providers by Krutika Parasar Raulkar, MD 

Texts from my husband:

Thursday 1:18 p.m.: Calling us for resp distress. Asking if we should be concerned for covid. Not really sure. Doesn’t have any risk factors but idk.
5:08 p.m.: Wondering if I should take extra precautions if we tube.

Friday 7:21 a.m.: I’m being emergently credentialed as an attending in the ED!

Saturday 12:34 p.m.: They just cancelled my oral boards.
Sunday 6:18 a.m.: Another covid rule out.
Monday 3:08 p.m.: Cleared out the surgical patients for covid overflow.
Tuesday 6:29 a.m.: Almost out of N95s. Gonna have to reuse them.
Wednesday 11:40 a.m.: Every icu is turning into a covid icu.
Thursday 6:48 a.m.: 2 covid positive codes overnight. No real way to protect ourselves. It’s really bad.
Today 5:49 p.m.: Almost out of vents…

I didn’t start out thinking I was going to be a physician. I was going to be an actor. I committed myself to a life of emotional expression, artistic fulfillment and likely poverty, and pursued an undergraduate conservatory degree in theater, which I quickly found is one of the most nebulous forms of education one can obtain. Rolling around on the floor, drawing classmates nude, and learning to imagine hot coffee in an empty cup were all part of a curriculum crafted to create the ideal artist. As an actor, there is relatively little structure or guidance, and there are almost never definitive answers. Much of the time, the emotion one feels and that which can be conveyed to an audience is more valuable an answer than simple mathematics or a binary solution to a problem. I was taught to strip down to my most vulnerable in order to learn and experience my most basic, rawest truth. I asked myself difficult questions, soul-searching daily in order to find not an answer, but a human representation of the struggle and search that is common and relatable to all people. There are no “yes or no” questions in acting, and so the actor lives forever in uncertainty. And when I decided that I would always love acting, but that I no longer wanted to pursue it as a career, a portion of my decision was because I wanted to know not only from where my next paycheck would come, but also because I was tired of the extreme subjectivity of everything within the field. I didn’t want that uncertainty.

I chose to become a physician because I asked too many “whys.” I wanted to know why things were the way they were, why a character — a person — behaved or moved in the way that he or she did. I wanted to understand people and, rather than put that on stage, use it to help them. And get answers, I did. In medical school, I learned to retrain my brain to understand that pathologies have pathways and medications have mechanisms and people die because something somewhere shuts down and we can track it to that very chemical moment. Questions had answers and science was made up of facts.

But the longer I’ve been a physician, the more I’ve realized that, despite our answers, we make a practice of living with uncertainty. Deciding when to watch and when to take action. Picking which treatment plan is going to help and which is going to harm. Predicting whether or not a patient’s paretic limb function will return or whether they will walk again. Choosing when to tell a patient’s family to come in because their loved one probably isn’t going to make it through the night. Now, more than ever, we live in times of uncertainty.

I’m married to an emergency medicine-critical care doctor. He is on the front lines, for lack of a better term, of the COVID-19 pandemic. He is exposed on a daily basis. He will likely start to show symptoms at some point. Every morning, I tell him to be safe, as if somehow saying it will make a difference. And here I am, a physiatrist, waiting, as physiatrists do, for the downstream effects. For patients to be transferred to clear beds. For them to survive long enough to make it to the floor. For my husband to get sick. For me to be exposed. For the world to keep shutting down. For things to get better. As I wait, I find myself thinking back to my training as an actor. It’s my construct for uncertainty. It is forcing me to be alright with not having the answers. And I suppose, in some ways, the not knowing is the art of medicine. It is the vulnerability that makes us, as physicians, human.

In her book COVID-19: Inside the Global Epicenter: Personal Accounts from NYC Frontline Healthcare Providers, Dr. Raulkar shares insider accounts of the deadly pandemic from one of the hardest hit medical systems in the world. Packed with the most current medical information, a historical account of the discovery and political reaction to COVID-19, and inspiring accounts and photos of frontline health care workers, this book provides the knowledge you need to stay well-informed about COVID-19, and hope and optimism to get you through these challenging times.

Krutika Parasar Raulkar, MD Krutika Parasar Raulkar, MD (4 Posts)

Attending Physician Guest Writer

NewYork-Presbyterian Columbia/Cornell

Krutika Parasar Raulkar completed her Physical Medicine and Rehabilitation residency at NewYork-Presbyterian/Columbia/Cornell, where she served during the pandemic. She graduated magna cum laude from Brown University in 2012 and attended Rutgers Robert Wood Johnson Medical School, where she was elected to the Gold Humanism Honor Society and received distinctions in Medical Education and Community Service. An exercise enthusiast, she has run three marathons and enjoys a myriad of sports/fitness activities. Her first book, Exercise as Medicine, was published by Wild Brilliance Press in 2018. The same year, Dr. Raulkar was featured on the Dr. Oz show for her care of Montel Williams after he suffered a stroke and received rehabilitation at Weill Cornell Medical Center. Following residency, Dr. Raulkar moved to Chapel Hill, North Carolina, where she lives with her husband and children, her lifelong partners in health and happiness.

In 2020, she published her second book, COVID-19: Inside the Global Epicenter, featuring New York City health care providers’ experiences from the peak of the pandemic.